Title Surgical Treatment in Conjunction With Air Polishing Powder Reduces Inflammation Associated With Peri-Implantitis
Clinical Question For patients experiencing peri-implantitis and undergoing surgical treatment, will surgical treatment plus air-polishing powder better reduce inflammation around the implant compared to surgical treatment alone?
Clinical Bottom Line Decontamination of implants by air polishing significantly reduced inflammatory agents and promoted guided bone regeneration.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
26065025Taschieri/201582 patients in 5 studiesSystematic review of non-randomized trials
Key resultsAll five studies included oral surgical protocol procedures along with the additional implementation of air abrasive powder. The prospective study by Behneke showed significant reduction in depth of bone loss after 3 years (p=0.001) and significant reduction in width of bone loss after 3 years (p=0.002). The case series study by De Mendonca indicated significant reduction in probing depth and TNF-alpha levels after 1 year (p<0.05). The prospective studies by Maximo and Duarte and the retrospective study completed by Toma also indicated significant improvements in all clinical parameters after 3 months for the first 2 studies and 1 year for the last study (p<0.05).
Evidence Search (("dental health services"[MeSH Terms] OR ("dental"[All Fields] AND "health"[All Fields] AND "services"[All Fields]) OR "dental health services"[All Fields] OR "dental"[All Fields]) AND ("air"[MeSH Terms] OR "air"[All Fields]) AND polishing[All Fields]) AND (Clinical Trial [ptyp] OR Meta-Analysis [ptyp] OR systematic [sb])
Comments on
The Evidence
Validity: The study by Taschieri et al. was a systematic review of 3 prospective studies, 1 retrospective study and a case series. There was a comprehensive and detailed search for relevant trials where each study was assessed for validity. No meta-analysis could be performed. The studies concluded that air powder abrasives were significantly associated with guided bone regeneration, improved clinical parameters such as probing depth and clinical attachment level, and reducing bacteria and TNF alpha levels around the implant. Perspective: Based on this systemic review, air polishing is a reasonable addition to surgical procedures in order to reduce inflammation secondary to peri-implantitis. However larger sample sizes and longer studies should be performed to further validate the addition of air polishing protocol to periodontal surgical procedures. It should also be noted that four of the studies showed significant improvement in clinical parameters (PD, BI, CAL, etc) and/or inflammatory factors after air-abrasive powder and surgical intervention, but only the Toma study provided evidence to show that such improvement could be attributable to air-abrasive powder as an adjunct to surgical therapy. Therefore, further trials are needed comparing air-abrasive powder and surgical intervention to surgical intervention alone, as well as trials comparing various surgical adjuncts to each other (air-abrasive powder, ultrasonic cleaning with carbon-fiber tips, etc).
Applicability As implant placements become more common in clinical practice the possibility of implant failures is a consideration. Implant failures can be attributed to peri-implantitis and its accompanying bone loss, which is the result of contaminated implant surfaces. The results from this study support the addition of air polishing during surgical treatment of peri-implantitis to increase the survival rate of implants. Furthermore, there were no potential harms listed as a result of air polishing. However, the additional expense for the surgical procedures was not discussed.
Specialty (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords air polishing, air abrasive, glycine, peri-implant disease, and peri-implantitis
ID# 2999
Date of submission 03/08/2016
E-mail ngc@livemail.uthscsa.edu
Author Chris Ng
Co-author(s) e-mail
Faculty mentor Moshtagh R. Farokhi, DDS, MPH
Faculty mentor e-mail Farokhi@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available